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General NPI Number Information
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NPI Number | 1710117882
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Entity Type | Individual
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Provider Name | TERRY HEPTINSTALL MA, LMFT, LPCC
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Gender | Male
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 03/12/2017
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Provider Practice Location Address
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Address Line | 23282 MILL CREEK DR STE 220
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1678
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Country | US
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Telephone | 714-264-5456
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Fax |
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Provider Business Mailing Address
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Address Line | 23282 MILL CREEK DR STE 220
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1678
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Country | US
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Telephone | 714-264-5456
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT47075
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCC 1622
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License Number State | CA
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